Annual Report Division of Hematology, Department of Medicine Sir

Annual Report
Division of Hematology, Department of Medicine
Sir Mortimer B. Davis - Jewish General Hospital
April 1, 2006 - March 31, 2007
I. Highlights
A) Opening of Segal Cancer Center
This year marked the first year of operation of the Hematology-Oncology activity in the new Segal
Cancer Center. Drs. Caplan, Gyger, Patenaude and Shamy relocated their office and hematologyoncology clinical activities to the 7th floor of the Segal Cancer Center. The impact of this new facility,
both on patients and staff involved in the care of hematology cancer patients has been enormous. In
addition to allowing increased interaction between all physicians and staff caring for cancer patients,
there have been important beneficial effects for patient care and academic productivity. The
availability of additional examining rooms, conference space, blood taking facilities and volunteer
services from Hope and Cope has created a positive environment for all those involved in cancer care
treatment.
In Hematology-Oncology, clinic space has been allocated for specialty clinics including the CML and
myeloproliferative disorder (MPD) clinics allowing for integrated care and increasing accrual of
patients on innovative clinical trials. Furthermore, the facility and the reputation of the Jewish General
Hospital’s oncology effort has increased the number of new patient referrals, requests for second
opinions and innovative therapeutic programs available through the Segal Cancer Center. The
enthusiasm that has been generated as a result of this new facility has created a new era of collaboration
within the oncology community at the Jewish General Hospital. Additionally, the acquisition of a
devoted specialized nurse in hematology (infirmary pivot) has had important positive impacts on
continuity and humanization of patient care.
B) Stem Cell Transplant Program
The Jewish General Hospital’s hematology stem cell transplant program remains a strong component
of the McGill Bone Marrow Transplant Program. The Jewish General Hospital continues to perform
35-40 autologous stem cell transplants with the main focus of activity in multiple myeloma, Hodgkin’s
and non-Hodgkin’s lymphoma and acute leukemia. Dr. Martin Gyger continues to provide leadership
for our efforts in this area and maintains close collaboration with our MUHC partners and with
colleagues at the Hôpital Maisonneuve-Rosemont. This year has seen the recognition of the Ministry
of the McGill Bone Marrow Transplant Program and included within it, the official designation of the
Jewish General Hospital as a center for performing autologous stem cell transplants.
C) Clinician-scientists
Drs. Galipeau and Blostein again continue their active basic science laboratories in the Lady Davis
Institute. Both have been awarded career awards from the FRSQ and continue to be successful in
publishing their research findings in high impact scientific journals.
D) Molecular Diagnostics Laboratory
The Jewish General Hospital remains as the referral hospital for molecular diagnostics for the entire
McGill hematology university network. New molecular studies have been initiated for chronic
lymphocytic leukemia, myeloproliferative disorders and lymphoma. Our molecular laboratory serves
as the sole laboratory engaged in teaching of molecular diagnostics to hematology fellows and
continues to perform chimerism studies for patients undergoing non- myeloablative conditioning
regimens.
E) CML Clinic
The CML clinic under the directorship of Dr. Carlo Gambacorti continues to remain as a unique entity
in the province providing highly specialized care to patients with chronic myelogeneous leukemia and
offering innovative clinical trials to their patient population. The clinic is now following nearly 50
patients with this disorder, the largest single clinic for this disease in Quebec. Physicians participating
in this activity include Dr. Sarit Assouline from the Lakeshore General Hospital and Dr. Jaroslav
Prchal from St. Mary’s Hospital.
F) Myeloproliferative disorder - MPD clinic
Dr. Prchal has proposed the initiation of an MPD clinic which is scheduled to start in mid-2007 to
provide highly specialized care to patients with polycythemia vera, essential thrombocythemia and
myelofibrosis. Dr. Prchal is a member of a large international consortium which has successfully
applied to the National Cancer Institute in the United States for funding for research and clinical trials
in myeloproliferative disorders.
II. Evaluation of Past Academic Year
1) Teaching Activities
The Jewish General Hospital’s Division of Hematology has been an important component of
the McGill Hematology fellowship program providing a rich learning environment for both
laboratory and clinical activities in hematology. Dr. Wahbi Hammouda had been primarily
responsible for much of the laboratory teaching activity and has been lauded for his excellence
in this area. The Jewish General Hospital’s division has been pointed out in recent accreditation
reports by the Royal College of Physicians as one of the strongest components of the McGill
Hematology Fellowship Training Program.
Guest Lecturer:
-Martin Dreyling, MD, University of Munchen-Grosshadern, Munchen, Germany
“Evolving role of radioimmune therapy in non-Hodgkin’s lymphoma and practicalities in
selecting patients”, Wednesday, September 27, 2006.
-Peter Hillmen, MD, Leeds Teaching Hospital NHS in the United Kingdom, “Optimizing
chemotherapy and monoclonal antibody therapy in CLL”, Thursday, February 8, 2007
-Kanti Rai, Albert Einstein College of Medicine, Long Island Jewish Medical Center, New
York
“Recent advances in the treatment of CLL (Chronic lymphocytic leukemia)”, Monday, May 10,
2007.
Blostein, Mark, MD, FRCPC
-Dept. of Medicine, Hematology for First year Medical Students
-Dept. of Medicine, Laboratory teaching to hematology fellows
-Dept. of Medicine, ICM-B
-Dept. of Medicine, Back-to-Basics
-Dept. of Medicine, Senior Physician Rounds
-Dept. of Medicine, Ward Attending, 7NW, 4 weeks/year
-Dept. of Physiology, Course Coordinator for PGY 515A
Caplan, Stephen N., MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
-Teaching: Small group tutor – McGill University
-Clinical Teaching Unit Attending 7NW
Galipeau, Jacques, MD, FRCPC
-Clinical Teaching Unit Attending, 7NW, SMBD-JGH, 3 weeks.
-Ward Attending, Clinical Teaching Unit (Internal Medicine): : 3 weeks June 2006.
McGill Graduate Courses - Lecturer
-"Gene transfer to hematopoietic stem cells”, Physiology of Blood graduate course: 516 B, Dept
of Physiology, McGill University, Course Coordinator Premysl Ponka, PhD
-"Cancer Gene Therapy”, Graduate course, Experimental & Clinical Oncology Course 516635D, Course Coordinator Wilson Miller.
-"Cancer Gene Therapy”, Graduate course, Cellular and Applied Immunology Course PHGY
513B, Course Coordinator Julie Desbarats, 2006.
McGill Undergraduate Courses - Lecturer
-"Gene Therapy”, Undergraduate Medical School course (McGill University), Unit 8:
Pathobiology, Prevention and Treatment of Disease - INDS 208A, Department of Medical
Genetics.
-"A Conceptual Approach to Hematological Malignancies”, Undergraduate Medical School
course (McGill University), Unit 5: Hematological and musculoskeletal systems - INDS 102,
Department of Medicine.
Gyger, Martin, MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
-Teaching: Small group tutor – McGill University
Hammouda, Wahbi, MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
-Teaching – Small group tutor – McGill University
Miller, Wilson, MD
-McGill University Free Radical Biomedicine Neurology Course 550, Lecture on “Free radicals
and cancer,” March 13, 2006.
-McGill University Physiology of Blood II: Course 522-516B, Lecture and seminar on "Acute
promyelocytic leukaemia," 3 hours, April 3, 2006.
-Co-Course Director, Experimental and Clinical Oncology #516-635D, Fall and Spring Terms,
2006-2007.
-Co-Course Director, Molecular and Cellular Biology Topics, 42 hours, Fall Term, 2006.
Monczak, Yury, PhD
Patenaude, Francois, MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
Ponka, Prem, MD PhD
Rosenberg, Arthur, MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
Shamy, April A., MD, FRCPC
-Consult service
-Laboratory teaching to hematology fellows
-Teaching – Small group tutor – McGill University
-Clinical Teaching Unit Attending 7NW
-Ward sign in rounds 7NW
2) Research
Blostein, Mark, MD, FRCPC
-Co-Investigator 25%, Principal Investigator: Galipeau, J, Fonds de la recherche scientifique du
Québec, “Gene Therapy of Hemophilia B”: $152,717, 3 years, starting September 2004.
-Co- investigator of a clinical trial/ 10%, Canadian Institutes for Health Research (CIHR),
$600,000, 3 years, starting March 2005, “Randomized Trial of Oral Vitamin K for WarfarinInduced Coagulaopathy”
-Co-investigator of a clinical trial/5%, Canadian Institutes for Health Research (CIHR),
$600,000, 3 years, starting March 2006, “Thrombophilia in Pregnancy Prophylaxis Study”
-Co-investigator of a clinical trial/ 10%, Canadian Institutes for Health Research (CIHR),
$540,000, 4 years starting March 2006, “A double blind randomized control trial of
postoperative low molecular weight heparin bridging therapy versus placebo bridging therapy
for patients”
-Co-Investigator 3%, (PI Weitz, J), Canadian Institutes for Health Research (CIHR), CIHR
Team Grant in Venous thromboembolism, $4,400,000, 5 years starting March 2006
Galipeau, Jacques, MD,FRCPC
-Dr. Galipeau's laboratory has been very active in developing regenerative medicine on a
Regional, National and International scope. From a regional perspective, Dr. Galipeau has
consolidated a collaborative link with the CHU Mère-Enfant (Ste-Justine Hospital) and the
Université de Montréal School of Veterinary Medicine with a major FRSQ grant exploring the
use of gene-engineered cells for therapy of haematological disorders:
Principal Investigator, Programme Hémovigilance FRSQ, $900,000 over 3 years,
“Regroupement stratégique québécois pour la recherche et le développement de la thérapie
cellulaire et génique pour les maladies hémovasculaires”, 2007-2010
-On a national perspective, Dr. Galipeau plays a major leadership role within the Canadian
Stem Cell Network as therapeutics theme leader and he leads a major collaborative effort
between McGill, UHN, U of Ottawa and UBC in Cardiovascular regenerative Medicine:
-Principal Investigator, Regenerative Medicine and Nanomedicine: Innovative Approaches in
Health Research - New Emerging Team Grant Program. (CIHR RMF 72553). Cardiovascular
and Respiratory Stem Cell Plasticity - CARE project. $1,500,000 over 5 years. 2004-2009
The LDI and UHN are participating in an industry-sponsored cell therapy study investigating
the use of gene-engineered autologous endothelial progenitor cells for treatment of pulmonary
hypertension. The first such patient treated outside of Toronto will be cared for at the JGH in
May 2007.
3) Clinical Activities (also included in 1) Teaching Activities)
Since the relocation of the hematology-oncology component of the division to the 7th floor at
the Segal Cancer Centre, the division has undergone a major transformation by now separating
its activities in benign and malignant hematology. All of the division’s activities in cancer are
now concentrated in the Segal Cancer Centre and all activity related to benign disease including
thrombosis continue to be offered in the existing location on the first floor of Pavilion E. As a
result of the movement of several physicians from the first floor, space has been freed to
provide reasonable office space to Dr. Mark Blostein, the thrombosis secretariat and the
thrombosis research nurses. The division of activities into benign and malignant, however, has
created new challenges with regard to staffing and physical distances between members of the
division. Nonetheless, the positive aspects of the relocation to the Segal Cancer Centre in terms
of providing additional examining room and office space, has outweighed the challenges and
difficulties resulting from the division of activities within hematology.
4) Academic Staff
The departure of Dr. Wahbi Hammouda as of February 1st, 2007 has created some challenges
and opportunities. Dr. Hammouda had played an essential role in the teaching program and as
Director of the Coagulation laboratories in our division for many years and had been recognized
for his expertise particularly in the area of circulating anticoagulants and the lupus
anticoagulant in particular. On the other hand, Dr. Hammouda’s departure has allowed us to
develop plans to recruit Dr. Sarit Assouline as a full-time member of our division. Dr.
Assouline has been a part- time member since July 2005 with her primary appointment at the
Lakeshore General Hospital. She has played an important role in the setting up, coordination
and directorship of our Hematology Tumour Board. In addition, she has had primary
responsibility for the acquisition of new phase I and II clinical trials in hematology-oncology.
Her relocation to the Jewish General Hospital will now allow her to fully pursue her academic
goals and to develop a strong clinical trials program in hematology-oncology here and in the
McGill University Department of Oncology.
5) Consulting Activities
None reported
6) Honours, Awards and Prizes
Galipeau Jacques, MD
-Our international outreach in cellular therapeutics takes place at the basic research level as
highlighted by a recent major award from the Roche Foundation for Anemia Research:
Principal Investigator: Eliopoulos N., MD, and Galipeau J. Co-applicant, Award from the
Roche Foundation for Anemia Research - RoFAR, $750,000 over 3 years, Cell and Gene
Therapy with Erythropoietin-Secreting Marrow Stem Cells for Kidney Repair”, 2007-2010
7) Other Activities
Blostein, Mark, MD, FRCPC
-Director, Anticoagulation Clinic
-Director, Coagulation Laboratories
-Consultation attending for both the Hematology and Thrombosis services
-Outpatient clinics in General Hematology and Thrombosis
-Member of the Research Ethics Committee Committees
-Canadian Institute for Health Research, Experimental Medicine (Operating Grant Reviews),
September 2005 – March 2006
Galipeau, Jacques, MD
-"Gammopathies" seminar given at the McGill Faculty of Medicine 57th Annual Refresher
Course for Family Physicians, November 27th 2006.
-Lead organizer for the 1st Quebec/New Jersey Stem Cell Workshop to be hosted at the MNI
and sponsored by McGill University and the Canadian Stem Cell Network, June 4-5 2007.
Gambacorti, Carlo MD
-Leading the CML Clinic providing specialized care to patients with chronic myelogeneous
leukemia
Gyger, Martin, MD, FRCPC
-Leader, SMBD-JGH Stem Cell Transplant Program, 35-40 autologous stem cell transplants
performed with the main focus of activity in multiple myeloma, Hodgkin’s and non-Hodgkin’s
lymphoma and acute leukemia.
Organization
-Hematopathology Rounds
-Stem Cell Transplantation Rounds
Hammouda, Wahbi, MD, FRCPC
-Member, Post graduate training committee in hematology at McGill University
Miller, Wilson, MD
-Director, Clinical Research Unit, Jewish General Hospital, Montreal PQ, 12/1997.
-Director, McGill University Department of Oncology Developmental Therapeutics Program,
9/2001-.
-Member, Management Committee, McGill University Department of Oncology, 9/2001-.
-Co-Director, Clinical Research Program, McGill University Department of Oncology, March
2002-.
-Director, Program Advisory Committee of the CIHR Training Program in Oncology, Montreal
Centre for Experimental Therapeutics in Cancer 2002-2008.
-Member, NSABP Foundation Research Program Steering Committee, June 2005-June 2008.
Prchal, Jaroslav Ferdinand
-Leader, MPD Clinic, providing highly specialized care to patients with polycythemia vera,
essential thrombocythemia and myelofibrosis.
Shamy, April A., MD, FRCPC
Organization
-Hematology Journal Club
-Hematology lecture series,
-Core Hematology Rounds
-CTU Director – Hematology-Oncology-7NW
Member
-Policy Committee
-Clinical Services Committee
-Residency Training Committee
7) Publications
Reviewed Publications (Past Twelve Months)
--Tagalakis, V, Kahn, S, Correa, JA, Libman, Solymoss, S, Miller, M., Blostein, MD,
Thrombophilia in short peripheral catheter thrombophlebitis Thromb. Res. 2006 Jul 1 (in press)
--Tagalakis, V, Blostein, MD, Robinson-Cohen, C, Kahn, SR, The effect of anti-coagulants on
cancer risk and survival: systematic review. Cancer Treatment Reviews, (in press)
--Tagalakis, V, Tamin, SR, Blostein, MD, Collet, JA, Hanley, JA, Kahn, SR, Warfarin use and
the risk of urogenital cancer, a nested case control study. Lancet Oncology, 2007 (in press).
--Eliopoulos, N, Gagnon, RF, Francois, M, Galipeau, J, Erythropoietin Delivery by
Genetically- Engineered Bone Marrow Stromal Cells for Correction of Anemia in Mice with
Chronic Renal Failure. Journal of the American Society of Nephrology; 17(6):1576-1584, 2006
Jun.
--Jaalouk, D, Crosato, M, Brodt, P, Galipeau, J, Inhibition of Histone Deacetylation in
Retroviral Packaging Cell Lines Markedly Improves the Production of Self-Inactivating
Retroviral Vectors. Virology Journal, 3:27, 2006.
--Jaalouk, DE, Lejeune, L, Couture, C, Galipeau, J, A Self-Inactivating Retrovector
Incorporating the IL-2 Promoter for Activation-Induced Transgene Expression in Genetically
Engineered T-Cells. Virol. J. 2006 Nov 21; 3(1):97 [Epub ahead of print]
--Jimenez, T, Fox, W, Naus, C, Galipeau, J, Belliveau, D, Connexin Over-Expression
Differentially Suppresses Glioma Growth and Contributes to the Bystander Effect Following
HSV- Thymidine Kinase Gene Therapy. Cell Communication and Adhesion; 13(1):79-92, 2006
Jan-Apr.
--Meriane, M, Duhamel, S, Lejeune, L, Galipeau, J, Annabi, B, Cooperation of matrix
metalloproteinases with the RhoA/ROCK and MEK1/ERK signalling pathways is required for
the sphingosine-1-phosphate-induced mobilization of marrow-derived stromal cells. Stem
Cells; 24; 2557-2565, 2006.
--Pommey, S, Galipeau, J, The use of Mesenchymal Stromal Cells in oncology and cell
therapy. Bulletin du Cancer. Volume 93, Number 9, 901-7, September 2006.
--Rafei, M, Wu, JH, Lejeune, L, François, M, Galipeau, J, The Generation of a GMCSF-IL15
transgene (GIFT15) with novel immunosuppressive properties. Blood. Nov 2, 2006; [Epub
ahead of print].
--Stagg, J, Pommey, S, Eliopoulos, N, Galipeau, J, Interferon-Stimulated Marrow Stromal
Cells: A New Type of Non-Hematopoietic Antigen Presenting Cell. Blood; 107:2570-2577,
2006 Mar 15.
--Al-Shughair, N, Al-Dawsari, G, Gyger, M, Mohamed, G, Roberts, G, Clinical significance of
plasmacytosis in the Day +14 bone marrow of acute myeloid leukemia patients undergoing
induction chemotherapy. J. Clin. Pathol. 10.1136, 26 May 2006.
--Kovarikova, P, Klimes, J, Sterba, M, Popelova, O, Gersl, V, Ponka, P, HPLC determination
of a novel aroylhydrazone iron chelator (0-108) in rabbit plasma and its application to a pilot
pharmacokinetic study. J Chromatogr. B Analyst Technol. Biomed. Life Science 838, 107-112,
2006.
--Mikhael, M, Kim, SF, Schranzhofer, M, Soe-Lin, S, Sheftel, AD, Mullner, E, Ponka, P, Iron
regulatory protein-independent regulation of ferritin synthesis by nitrogen monoxide. FEBS J
273, 3828-3836, 2006.
--Nie, G, Chen, G, Sheftel, AD, Pantopoulos, K, Ponka, P, Effects of mitchondrial ferritin
expression on tumor iron metabolism and on tumor growth in nude mice xenografts. Blood 108:
2428-2434, 2006. This article was accomplished by Editorial Commentary by Richardson,
D.B., Lovejoy, DR, Iron mining to inhibit tumor growth. Blood 108: 2140, 2006.
--Ponka, P, Genetically-based iron deficient erythropoiesis. Hematology Digest Newsletter
(The Johns Hopkins University School of Medicine), Volume 1, Issue 8, April 2006).
--Ponka, P, Sheftel, AD, It’s hepcidin again, but is it the only master? Blood 108, 3631-3632,
2006.
--Ponka, P, Tenenbein, M, Eaton, J, Iron. In: Handbook on Toxicology of Metals, Third Ed. (
Nordberg, G, Fowler, BA, Nordberg, M, Fridberg, L, eds.) Elsevier, 2006.
--Sterba, M, Popelova, O, Simunek, T, Marzurova, Y, Potacova, A, Adamcova, M, Kaiserova,
H, Ponka, P, Gersl, V, Cardioprotective effects of a novel iron chelator, pyridoxal 2chlorbenzoyl hydrazone, in the rabbit model of daunorubicin-induced cardiotoxicity. J. Pharm.
and Exp. Therapy 319, 1336-1347, 2006.
--Watts, RN, Hawkins, C, Ponka, P*, Richardson, DR, Nitrogen monoxide (NO)-mediated iron
release from cells is linked to NO-induced glutatione efflux via multidrug resistance-associated
protein 1. Proc Natl Acad Science USA 103, 7670-7675, 2006. *Corresponding author.
--Whitnall, M, Howard, J, Ponka, P*, Richardson, DR, A novel class of iron chelators with a
wide spectrum of potent anti-tumor activity that overcomes resistance to chemotherapeutics.
Proc. Natl Acad. Science USA 103: 14901-14906, 2006. *Corresponding author.
--Yoon, D, Pastore, YD, Divoky, V., Liu, E, Mlodnicka, AE, Rainey, K, Ponka, P,
Semenza, GL, Schumacher, A, Prchal, JT, Schumacher, A, Prchal, JT, HIF-1
alpha-deficiency result in dysregulated EPO signaling and iron homeostasis in mouse
development. J. Biol. Chem. 281, 25703-25711, 2006.
--Zhang, AS, Sheftel, AD, Ponka, P, The anemia of “hemoglobin deficit” (hbd/hbd) mice is
caused by a defect in transferrin cycling. Exp. Hematol. 34, 593- 598, 2006.
Abstracts/Presentations:
--Ganopolsky, JG, Abid, R.,Varnum, B, Aird, W, Blostein, MD, GAS-6 rescues endothelial
cells from apoptosis through FOXO1 inactivation, GRC, 2006.
--Blostein, MD, Rajotte, I, Hasanbasic, I, Carboxylation is required for receptor dimerization
during gas6-Axl mediated endothelial cell survival, GRC, 2006.
--Tagalakis V, Tamim H, Collet JP, Kahn SR, Blostein MD, Hanley JA. The effect of warfarin
use on the risk or urogenital cancer. Pharmacoepidemiol. Drug Safety. 15: 133, 2006.
--Tagalakis V, Tamim H, Collet J, Kahn SR, Blostein M, Hanley JA, The effect of warfarin on
the risk of prostate cancer. J Clin Once. 24: 14524, 2006.
--Blostein, MD, Curquis, J, Galipeau, J, Galectin 3- Binding Protein contaminates the
purification of recombinant factor IX, Blood, 108: 1038, 2006.
--Ganopolsky, JG, Charbonneau, S, Peng, H., Blostein, MD, Characterization of an ideal
amphipathic peptide as potential hemostatic agent, Blood,108: 1618.
--Abou-Nassere, K, Rodger, M, Kovacs, M, Doucette, S, Tim, R, Kahn, S, Wells P, Robinson,
SR, Blostein, MD, Solymoss, S, Rey, E, The effect of dalteparin on Coagulation Activation
during Pregnancy in Women with Thrombophilia: A Randomized Trial, Blood, 108:874, 2006.
III. Objectives & Priorities
Dr. Sarit Assouline is scheduled to become a full time member of the division as of July 1st, 2007
Recruitment for future years includes Dr. Natalie Johnson who is currently receiving specialized
training in molecular hematology in Vancouver under the supervision of Dr. Randy Gascoyne and is
now enrolled in the PhD program at the University of British Columbia.
Dr. Peter Martin is currently at Cornell University in New York doing specialized training in biologic
therapies including new monoclonal antibodies for hematology-oncology and is also enrolled in the
Master’s Program in Clinical Investigation at Cornell.
Both Drs. Johnson and Martin are scheduled to join the division in 2008 or 2009.
Recruitment in Quebec remains a difficult and cumbersome process primarily related to arbitrary
quotas imposed on specialists, particularly hematology-oncology in large urban areas. The lack of a
combined hematology-oncology division makes the process of recruitment even more difficult since
the Ministry recognizes hematology-oncology as a single specialty. This leads to conflicts in
recruitment between oncology and hematology which must be settled by negotiation and goodwill. It is
hoped that the rigid structure at the governmental level will be changed in the near future and that
modifications can be made to alter the current structure at the Jewish General Hospital so that
hematology and oncology could function as a single unit.
The principle goals for the future will be to recruit young physicians with academic ambition and
appropriate training to accomplish their goals. This requires identification early on of residents during
their training, assisting them in finding the best academic programs to further their goals, and providing
an attractive environment to which they could be recruited and flourish as clinical or laboratory
researchers. The success of clinician-scientists hinges on planning to ensure mentoring by senior
physicians or scientists, protected time for research and a strong financial base to support their research
activities.
Respectfully submitted,
Stephen Caplan, MD, FRCPC
Chief, Division of Hematology
June 22, 2007